- Evolent (Albany, NY)
- …appeals. **What You Bring:** + 1-3 years' experience in clinical Appeals Review or Utilization Management Review as an LPN or LVN is required. + Must ... appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and...set up the appeal, physicians and other clinicians who review the appeal, the claims department to review… more
- New York State Civil Service (Monroe, NY)
- …psychology, research psychology, industrial psychology, organizational psychology, utilization review , guidance counseling, etc.Psychologist 2:Promotion: ... psychology, research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or… more
- MTA (Brooklyn, NY)
- …medical quality control reviews. This includes but is not limited to fast-track case management , expansion on mobile medical assessments and projects which will ... and Medical Director on creating training manuals, administrator training sessions , and case review . KNOWLEDGE, SKILLS, & ABILITIES : + Possess or acquires… more
- CCSI INC (Johnson City, NY)
- …. + Design and implement monitoring protocol to ensure appropriate utilization management and utilization review procedures are in place. + Respond ... This includes communication with partnering agencies, coordination and facilitation of complex case review sessions and partnering with existing Department staff… more
- City of New York (New York, NY)
- …living with HIV, as well as 8,000+ affected families. HASA provides intensive case management , rental assistance, emergency and permanent supportive housing, and ... of placement indicators, contractor/provider vacancy reports, placement reports and case review . Provide technical assistance to contractors/providers,… more
- Outreach Development Corporation (Brentwood, NY)
- …limited to computer skills training and oversight of vocational assessment/counseling, case management , coordination of on-site VESID services, educational ... in program and staff meetings, where appropriate. . Provide vocational/educational case management services for clients. . Provide crisis intervention… more
- Trinity Health (Albany, NY)
- …services. Primary responsibility is to provide on-site support and assistance to hospital case management and hospitalist team to ensure timely identification of ... have a unique opportunity for a RN to receive, review and process referrals of patients at St. Peter's...sources, and external payers regarding the effective and efficient utilization of program services and available resources. + Screening… more
- Outreach Development Corporation (Brentwood, NY)
- …Program Description + Facilitates case conferences, level of care assessments and utilization review in a timely manner and maintains record of old ... is responsible for assisting the Site Director with the management of the administrative and clinical components of the...reports: Units of Service, Vocational OASAS report, + Monthly Case Conference Calendar and other reports or systems indicated… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …care management rounds. + Provision of clinical oversight and leadership to Utilization Management / Case Management (UM/CM) staff working with the ... calls in timely manner and provides support for the Case Management (CM) and Registered Nurse (RN)...Develops and implements the BH sections of the Quality Management / Utilization Management (QM/UM) Plan, including… more
- Datavant (Albany, NY)
- …to appropriate management staff. + Provide status reporting and report management . Strong utilization of SalesForce to include monitoring and documenting ... ###@datavant.com . We will review your request for reasonable accommodation on a case -by- case basis. For more information about how we collect and use your… more
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